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Synchronous Ipsilateral Renal Cell and Transitional Cell Carcinomas: A Case Report

同時單側腎細胞癌與移行上皮細胞癌:病例報告

摘要


單側同時發生腎細胞癌與移行上皮細胞癌相當罕見,到2005年為止全世界的統計資料中僅有47位。我們報告一位78歲男性同時發生單側腎細胞癌與腎盂移行上皮細胞癌的病例。病患在10年前曾被診斷出右腎血管肌脂瘤(angiomyolipoma)但並未如期追蹤,6個月前以無症狀的血尿來求診,斷層掃描和血管攝影發現位於右腎下方有一個質地不均勻、突出的鈣化腫塊併有密集的微血管灌注,逆行性腎盂攝影則發現右上腎盂有顯影缺陷,尿液細胞學檢查亦證實有移行上皮細胞癌,在確認移行上皮細胞癌及懷疑腎細胞癌的前提下,幫病人施予右腎切除、輸尿管切除及膀胱袖口切除手術,術後病理報告顯示同時存在腎細胞癌及腎盂移行上皮細胞癌。

關鍵字

腎癌 腺瘤 移行上皮細胞癌

並列摘要


The simultaneous occurrence of ipsilateral transitional cell carcinoma (TCC) and renal cell carcinoma (RCC) is rare. There are 47 such cases in the published literature worldwide. We report on a 78-year-old man with synchronous ipsilateral renal adenocarcinoma and renal pelvic TCC. He was referred to our department due to asymptomatic gross hematuria for 6 months. A computed tomographic scan and renal angiography revealed a 6-cm renal mass, which was exophytic, heterogeneous, and hypervascular in the lower pole of the right kidney. Retrograde pyelography demonstrated a filling defect in the upper calyces of the right kidney. Under the impression of TCC by urine cytology and suspicion of RCC, a right nephroureterectomy and bladder cuff resection were performed. Pathological diagnosis revealed a grade 2 TCC and clear-cell RCC.

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